酒精性肝硬化患者死亡率分析

N. Matkovska
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摘要

背景。酒精被认为是世界各地不良事件死亡的主要风险因素。在乌克兰,酒精性肝病(ALD)造成的死亡率在消化系统疾病导致的死亡结构中排名第二。目标。本研究的目的是在病理解剖研究方案分析的基础上,探讨酒精性肝病肝硬化(LC)期患者死亡原因的特殊性。方法。2006-2018年,在伊万诺-弗兰科夫斯克地区临床医院病理解剖科对死于酒精性LC的患者的149份病理解剖研究方案进行了分析。结果。大多数人都是年轻人和中年人。死亡病例主要是肝、肝肾、心肺功能不全、胰腺坏死、胃肠道出血、脓毒症、肝细胞癌等肝脏失代偿所致。37.6%的患者合并冠心病,10.7%的患者合并高血压。6%的患者被诊断为缺血性脑卒中。大多数人可见动脉粥样硬化性血管改变。结论。酒精的过度消费以及由此导致的LC的发展可以被认为是降低社会生活水平的一个不利因素。在大多数死于酒精性LC失代偿的人群中,已经检测到动脉粥样硬化性血管病变。这表明酒精性LC患者存在显著的脂质代谢紊乱。
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MORTALITY ANALYSIS OF THE PATIENTS WITH ALCOHOLIC LIVER CIRRHOSIS
Background. Alcohol is considered to be the main risk factor for adverse event deaths around the world. In Ukraine, mortality due to alcoholic liver disease (ALD) has taken the second place in the structure of death causes from diseases of the digestive system. Objective. The aim of the research was to study the peculiarities of the causes of death in the patients with alcoholic liver disease at the stage of liver cirrhosis (LC) based on the analysis of protocols of pathoanatomical research. Methods. The analysis of 149 protocols of the pathoanatomical study of the patients, who died from alcoholic LC, has been carried out at the premises of the Pathoanatomical Department of the Ivano-Frankivsk Regional Clinical Hospital in 2006-2018. Results. Most people were young and middle aged. Fatal cases were caused by decompensation of the LC with the development of hepatic, hepatic-renal, cardio-pulmonary insufficiency, pancreatic necrosis, gastrointestinal bleeding (GIB), sepsis, hepatocellular carcinoma (HCC). In 37.6 % of the patients the concomitant illness was coronary heart disease (CHD), 10.7 % of the people had hypertension. In 6 % of the patients, ischemic stroke of the brain was diagnosed. In most people atherosclerotic vascular changes were revealed. Conclusions. Excessive consumption of alcohol and, consequently, the development of LC, can be considered as an adverse factor in the reducing social standard of living. In the majority of people, who died from the decompensation of alcoholic LC, atherosclerotic vascular lesions have been detected. This indicates a significant prevalence of lipid metabolism disturbance in the people with alcoholic LC.
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